The Misophonia Activation Scale (MAS-1) is intended to guide clinicians and patients in assessing the severity of a sufferer's condition. It concentrates on physical and emotional reactions to a particular misophonic trigger. It makes little reference to the status of the trigger person, i.e., as a known trigger or otherwise. Someone with misophonia may not necessarily exhibit all, or even many, of these behaviours. Also, some sufferers may experience symptoms in a different order, for instance, engaging in some "confrontational" coping behaviours before adopting more co-operative ones.

You might like to observe your reactions and create your own misophonia scale. You may not need eleven levels!

MAS-1 is a work in progress and may be updated in the light of published research. Suggestions for amendments and improvements are welcomed. If you are not clear about any of the terms used, please refer to our glossary. Author: Guy Fitzmaurice. Last content review: 16 July 2010.

Person with misophonia hears a known trigger sound but feels no discomfort.

Level 1

Person with misophonia is aware of the presence of a known trigger person but feels no, or minimal, anticipatory anxiety.

Level 2

Known trigger sound elicits minimal psychic discomfort, irritation or annoyance. No symptoms of panic or fight or flight response.

Level 3

Person with misophonia feels increasing levels of psychic discomfort but does not engage in any physical response. Sufferer may be hyper-vigilant to audio-visual stimuli.

Level 4

Person with misophonia engages in a minimal physical response - non-confrontational coping behaviours, such as asking the trigger person to stop making the noise, discreetly covering one ear, or by calmly moving away from the noise. No panic or flight or flight symptoms exhibited.

Level 5

Person with misophonia adopts more confrontational coping mechanisms, such as overtly covering their ears, mimicking the trigger person, engaging in other echolalias, or displaying overt irritation.

Level 6

Person with misophonia experiences substantial psychic discomfort. Symptoms of panic, and a fight or flight response, begin to engage.

Level 7

Person with misophonia experiences substantial psychic discomfort. Increasing use (louder, more frequent) use of confrontational coping mechanisms.There may be unwanted sexual arousal. Sufferer may re-imagine the trigger sound and visual cues over and over again, sometimes for weeks, months or even years after the event.

Panic/rage reaction in full swing. Conscious decision not to use violence on trigger person. Actual flight from vicinity of noise and/or use of physical violence on an inanimate object. Panic, anger or severe irritation may be manifest in sufferer's demeanour.

Level 10

Actual use of physical violence on a person or animal (i.e., a household pet). Violence may be inflicted on self (self-harming).